We can’t do it all, says NHS hospitals chief; NHS needs to “take a reality check” and limit what it funds, hospitals say

Initially posted under the title “We can’t do it all, says NHS hospitals chief”, Laura Donelly’s article 11th August changed to; “NHS needs to “take a reality check” and limit what it funds, hospitals say” on 12th August 2016. Is anyone listening to Mr Stevens or Mr Hopson, or reading Ms Donelly? We cannot have “Everything for everyone for ever” and so we need to decide what are our priorities for full funding, partial funding and no funding. Since we all pay the same taxes NHSreality thinks this needs to be National for the really expensive services. Liberal philosophy has to be modified in the face of National inequity and reasonable fear… Meanwhile even normally altruistic juniors are disengaged and feel no remorse in continued strike action … An NHSreality check if ever there was one

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The NHS needs to take a “reality check” about what it can provide and take national decisions about which treatments and services should be rationed, the leader of England’s hospitals has said.

The call came as official data showed the health service in the grip of the worst bedblocking crisis on record, while waiting lists are the highest for almost a decade, with 3.7 million people awaiting treatment.

Chris Hopson, head of NHS Providers, which represents hospitals, said politicians and health officials needed to face the fact the NHS could no longer meet all the demands on it.

He said an “honest debate with the public” was needed about what the health service could pay for, as it grapples with the worst deficit in its history, in the face of growing demand.

Mr Hopson said the NHS could not meet waiting targets, maintain quality, and balance its books, with latest figures demonstrating that “something has to give”.

We need a systematic and planned approach to this and we need to build a national consensus about what the priorities are,” he said.

“We can no longer do everything with the money that we have. We have to look at all the options – whether it’s restricting access to some treatments, changing the [waiting] targets, reducing the workforce, letting the deficits slide or deciding that we can no longer keep an Accident & Emergency department open, or that we can’t run two hospitals 20 miles away from each other,” he said.

The senior figure said most hospital chief executives opposed NHS charges for treatment, but many felt that greater rationing of free treatment was required, to prioritise the most essential care.

The data from NHS England shows a near doubling in the numbers of elderly patients stuck in hospital, for want of care at home, or help to get them discharged, in the past five years.

Overall, 115,425 bed days were lost to delayed discharges in June – almost 80 per cent more than the same month five years ago.

Just 90.5 per cent of patients who went to Accident & Emergency departments were seen within four hours, against a target of 95 per cent  – the worst June figures on record.

Ambulance response times were also a record low for the time of year, with just 69.2 per cent of the most urgent calls receiving a response within eight minutes, against a target of 75 per cent.

Charities said a funding crisis in social care meant thousands of vulnerable people were being left in hospital, when they should have been cared for in their homes.

Vicky McDermott, chairman of the Care and Support Alliance, which represents 80 charities for the elderly and disabled said: “The Government cannot continue to ignore the crisis that means that patients are stuck in hospital, when they could be at home.

“The funding crisis in social care is heaping needless pressure onto the NHS.”

Earlier this week NHS managers at University Lincolnshire Hospitals NHS trust said they were considering closing an Accident & Emergency (A&E) department at night after reaching “crisis point”.

NHS England defended the performance, pointing out that June saw the highest number of A&E attendances on record, with a 2.1 per cent increase on last year.

Health officials said some aspects of the performance showed an improvement on previous months.

A Department of Health spokesman said: “The NHS had its busiest June ever, but hospitals are performing well with nine out of ten people seen in A&E within four hours – almost 60,000 people per day seen within the standard.

“We are committed to delivering a safer seven day NHS which is why we have invested £10bn to fund the NHS’s own plan to transform services in the future,” he said.

In recent days, senior figures have raised concerns about growing levels of rationing across the NHS.

On Thursday, health officials in Merseyside announced plans to withdraw one of the most controversial proposals – the suspension of all non-urgent surgery for months.

The plans from St Helens clinical commissioning group had provoked a public outcry.

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This entry was posted in A Personal View, Junior Doctors, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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